 Welcome to tonight's COVID Town Hall briefing coordinated by the Greater Houston Partnership and Interfaith Ministries for Greater Houston. We've been hosting COVID updates since March of 2020. Between that time in May of 2021, we held one every week and have hosted them twice monthly, starting in August. Tonight's briefing with over 225 registrations was designed as an evening event for the overall community. We want to, as much as is reasonably possible, provide opportunities for people in our community to hear from medical experts on where we are with COVID, as well as the importance of the vaccine. Thank you to all of our guests that you will soon meet. Thank you to our guests support teams as well for assisting in coordinating schedules. Thank you to our team at Interfaith, Jody Bernstein, Sucre Woodley, Jet Phillips, Kim Mayberry, Martin Kaminsky, as well as thanks for the support of our board of directors. The announcements otherwise are simple. Please make sure to use either the chat box or the question and answer option you should see at the bottom in your toolbar. Please though, please make sure to ask a question. We will not get to every question and we'll start with the pre-submitted questions. We appreciate your patience. We could have made this a three hour webinar, but we have found that even if it means we cannot get to every question or touch on every issue that one hour is about the limit of reasonable engagement for people on zoom. And finally, a final reminder that this webinar is being recorded. Let me now welcome Pastor David Smith to offer a welcome. He is with the New Bethlehem Baptist Church and has been a preacher of the gospel for more than 27 years. A true Houstonian who loves this community has been recognized by public leaders ranging from mayors to state and national representatives for his leadership. And I will put him right there. Welcome, Pastor Smith. Good evening. First and foremost, I want to thank God for this opportunity, as well as Miss Bernstein, Miss Kim Mayberry and Reverend Han. I am related to be part of the Interfaith Ministries in 2020 during the pandemic and everything began to close down. The only information I was initially receiving was being communicated through the media. But it began to change from day to day with different emphasis for faith based communities. Pastor Dr. Steve Hall shared information with me about Interfaith Ministries, and I began to register and attend the Zoom calls. When I could not be on my secretary would register and listen in. I was grateful to receive an email from the minutes from Interfaith Ministries from each Zoom call and all the resources and information that provided. I even had pastors who were by vocation to call and ask what was going on as it related to safety protocols, capacities in the building. So I feel confident to follow the information I received from Interfaith Ministries. It is a blessing and a privilege that all faith based organizations can work together for the common cause of educating our congregants, as well as our communities. The virus of variant does not discriminate against religions. Education is important. And who does the community most trust. They trust their faith based leaders, and it is important for all of us to work together, along with the medical community. I believe it's important as faith based leaders to take the lead to vaccinate and to wear our mask, not only to protect ourselves, but to protect our families as well as others. We should trust the science, follow the CDC guidelines, and most of all, remain prayerful, just plain and simple. Again, thank you, Miss Bernstein, Miss Mabry, Reverend Hahn for this opportunity on this call today. May God bless and keep each and every one of you is my prayer. Thank you, Pastor Smith. Let me now recognize Mr Bob Harvey, who's the president and CEO of the Greater Houston partnership who's been our co partner in our coven information efforts, who will have a brief introduction and will then introduce our first two presenters. Bob, please. Well thank you Greg and good evening everyone thanks for joining us on this call. On behalf of the Greater Houston partnership I'm pleased to join with Interfaith Ministries for this our first ever evening program on the coven 19 pandemic. One role of the partnership is to convene you Stonians on issues of great importance and this is certainly one so thanks to all of you for attending. Before I introduce our first two speakers let me hit the highlights on our current situation here in Houston. As you know the Delta variant has driven this the fourth wave of the pandemic to new levels. When it comes to reported cases and hospitalizations. Looking at the Greater Houston region, we had a peak weekly average of reported positive COVID cases, the week before last. We believe this may represent the peak for this fourth wave but we can't be certain, particularly with schools reopening and the holiday weekend approaching. More troubling in many respects in the number of cases is the number of new COVID hospitalizations, people being admitted with COVID symptoms to our hospitals on a given day. Here I'm showing the TMC hospitals across their entire regional footprint. New hospitalizations hit record levels a week ago. And while they may have plateaued. It's at a very problematic level, as you will hear from our next two presenters. The total number of COVID patients being treated and our TMC hospitals reached an all time peak level just in the last few days. And this is what creates the real strain on the hospitals. Over 90% of these COVID patients are unvaccinated. When it comes to vaccination, we have a long way to go. Only 48% of the Harris County population is fully vaccinated 60% if you only include those 12 years of age or older. But unfortunately, some ethnic groups and some neighborhoods lag substantially when it comes to vaccination and we'll talk more about that issue shortly. I want to introduce the first two speakers. Dr. Esmail Porsa is president and CEO of Harris Health System, which is one of the largest safety net health systems in the country. He joined Harris Health in March of 2020 just days before the virus hit Houston. In addition to his MD degree Dr. Porsa has a master's degree from the UT School of Public Health and an MBA from UT Dallas. Next will be Dr. Lewis Ostrowski. Dr. Ostrowski is a professor of medicine and a division chief in the Division of Infectious Diseases of the McGovern Medical School, which is part of UT Health here in Houston. He is coordinating the COVID-19 response for UT Health and its affiliated hospitals and its clinics. Dr. Porsa, thanks for joining us. Let me give you the floor. Thank you so much. It's a pleasure and actually an honor to be among these distinguished guests. So thank you for having me. As I'm getting ready to share my screen. Let me start as always by thanking all of our health care staff at Harris Health System definitely by the rest of the health care systems here in the Houston area instead of Texas. This is one of the things that I've been dealing with this pandemic now for a year and a half. A little more than a year and a half. I'm going to spend a couple of minutes on this slide to kind of tell you a story. You know, the graphs should look familiar to you now. You know, we have the first search, not much of a search. This is a search from last summer. The search over the winter and the current search. As I want to say about the current search with the Delta variant, as you can see, the rate in the increase in the number of patients getting admitted to the Harris Health System is unprecedented. We've never had this rise, this rate of rise in numbers ever before in the pandemic. And a couple of days ago, we reached our highest number of COVID patients in my system, both in med search and also in the ICU. We had to kind of juxtaposition this fact against what you just saw about the number of cases and hospitalizations in the area. While it is true that may have reached potentially a peak in the number of cases of hospitalization, we are arriving at this very, very high peak, which is actually higher than any time before during the pandemic. I want to talk to you guys about some of these lines here. We know what they represent. You know, this was the phase one reopening in Texas on May 1. And as you can see, you know, we've resulted in a little bit of increase in the number of hospitalizations. We had the phase two reopening a little more increase in hospitalization. We had the phase three, which was the full opening of our economy June 3 of last year. And then result a huge jump in the number of cases. I say this to emphasize the fact that what we do know about the COVID-19, the science behind it is true. It's real. Lack of social distancing, lack of covering your face with the face mask does have an impact and we saw that in practice last year. While the numbers were going up, a couple of things happened. The bars were closed down on June 26. And then on July 2nd, there was a mandatory face mask order across the state. And lo and behold, 10-14 days later, we arrived at the peak and we saw a nice decline in the number of cases. This was not accidental. What happened directly as a result of practicing social distancing and covering our faces with face masks, plain and simple. Then we had the surge in the winter of last year. And again, at the height of the peak as the numbers were going up the bars were closed. And again, lo and behold, 10-14 days later, you start seeing in dropping the number of cases. The number of face masks was lifted on March 10th of this year. And the numbers continue to drop because the vaccines, COVID vaccines were introduced toward the end of December of last year. What is happening right now is a couple of things. One, we have a Delta variant, which is just a different beast and the original COVID-19, much more contagious and it's just behaving very differently. In addition to that, even though we have a vaccine that is very safe, very effective and fully approved by the FDA, unfortunately, we are seeing a different in the public's behavior as far as the wearing of the face mask social distancing, which is very unfortunate. My next couple of slides are basically going to make the same points. These are, you know, you hear a lot about the news and the numbers that are being presented and all the misinformation out there about the validity of the data. This is my data. This is data from Harris Health System. This is the data that I can store by. So since January 1 of this year, beginning of this calendar year, until just a couple of days ago in the August. Unfortunately, Harris Health System has with us 152 COVID related fatalities in the hospital, 152. Out of the 152, only three people were fully vaccinated. Now you can look at this two different ways. You know that the cynic may say, see, the vaccine doesn't work. People still died. In reality, what this slide is showing is that the odds of dying of COVID. If you are vaccinated versus if you are not vaccinated is 51 50 to one. You are 50 times more likely to die of COVID. If you are not vaccinated, then if you are, those are really, really good odds. We have vaccines that are extremely safe and extremely effective. This is basically making the same point. Those are the people who were hospitalized from the surge in the wintertime in the blue and the current search in the burnt orange. So you can see the number of people who were hospitalized and this is region six is that the states of Arkansas Louisiana New Mexico Oklahoma and Texas. The number of people admitted to the hospital for over the age of 60. The current search compared to the last search. There's a huge decline in the number of people admitted to the hospital. The reason for this is because vast majority of people over the age of 60 have been vaccinated. I share that to the people younger than 60. You see the opposite. More people are getting hospitalized now compared to the previous search. Again, I shared this information with you to make the point that we have the vaccines that are extremely safe and effective. Are the breakthrough infections. Absolutely. No one has ever claimed that the vaccines are 100% effective. They are breakthrough infections. But what I'd like to emphasize is the fact that the vaccines are effective. Highly effective against severe illness and are highly effective against death due to COVID-19. You know, I showed you the numbers about the folks dying in the hospital, my hospitals. I showed you the numbers about the people getting admitted to the intensive care unit. 98% are unvaccinated and only 2% vaccinated and we started numbers with fatalities. Again, we have the vaccine that is extremely safe and the other thing that I hear sometimes is that, you know, why should we get the vaccine. If you still have to wear a face mask. Remember what I said that the vaccines are extremely effective not 100%. And to add to that covering up your face with a face mask is an additive effect you're protecting yourself, even more. And also remember a breakthrough infection does not mean that you die of COVID. And I just show you the odds of dying with COVID. If you're vaccinated versus when you're not vaccinated 50 to one. And we can transition to Dr. Strosky and then at the end, I'll be happy to answer any questions. Thank you very much, Dr. Porsa. And I'd like to start by thanking the organizers of this town hall interfaith ministries and a greater Houston partnership. And I always treasure the opportunity to share some of the things we have been learning about this devastating disease. Again, I'm Luisa Strosky. I'm the chief of infectious diseases for UT health. And I want to start really with the fact that this is not a blip in in in the map. It's not a minor inconvenience. It's not just a flu. This is a history changing event we're living right now, where we're tearing the fundamental fabric of medicine. We have culture civilization economy, you name it, we're having an effect. This is a disease that has caused really over 200 million cases worldwide. We have lost almost 5 million people to this devastating disease. And in the largest vaccination campaign ever, we have vaccinated nearly 5 billion people in the course of a year. So, again, not just a blip in the map here. I also want to bring it to the US. Again, we're experiencing our fourth wave at this point. This red map shows you areas in the United States with high community transmission of COVID-19. And as you can see, basically the whole United States is in the red at this point. And again, I want to bring to your attention that we have lost nearly 650,000 lives to this disease. This is more now than the 1918 flu pandemic. And more than any war or conflict the United States has ever participated in. So this is how powerful this disease is. And again, this is data to show that we're not just going through another flu or another respiratory virus in the community. As was discussed, we're currently experiencing a surge that's primarily driven by the Delta variant of this virus. This variant is originated in India, is spreading worldwide. More than 95% of cases in the US and in the Houston area are caused by this variant. And the relevance of knowing which variant we're talking about is that this variant is slightly more lethal than the reference strains. And it is definitely more transmissible. How much more transmissible it is in the range of one of the most transmissible virus we know, which is chickenpox. So we have the perfect storm here, something that's a little bit more lethal than influenza with the transmissibility rates of chickenpox. And that is why we're living a fourth surge at this point in time. Mr. Harvey shared the TMC data. This are very carefully curated graphs that are published on a daily and weekly basis. And what this gauge is tell us is that we have ongoing transmission in the community. We have a possibility rate that greatly exceeds the 5% that is manageable. And again, to put it under perspective, when we're at 5%, one out of 20 people you encounter are going to be carrying the virus. But when we're at 20%, it's one out of five. So if you're in a room with five people outside at least one of those people are going to have COVID. And the number of cases we're seeing on a daily basis in Houston does not make it feasible to contact trace isolate look for other exposures, etc. This is just out of control in the community. So fortunately, it looks like we are plateauing too early to tell us Mr. Harvey was saying, but I do want to emphasize that although we're plateauing, we're plateauing at 100 miles an hour. We have a very high case load. Our hospitals are full beyond their normal ICU capacity. So we deploy nurses to jobs they know don't normally do doctors as well. We're taking over units that normally house surgical patients and other types of patients for COVID. And this is affecting not only the people that are experiencing the code, but the community as a whole because we're having to postpone elective surgeries we have to the fair care for cardiac patients for oncology patients. And this is a problem that is not only affecting those who have COVID but the community as a whole. And it's something we need to work on as a community together. This is forecasting and this is very interesting from the center services control. And as you can see here in the forecast for Texas, and for Harris County in particular, we are expected to start going down a little bit over the next two weeks. In bad news, we're then expected to go a little bit up. And again, this is most likely going to be driven by the schools going back to session in person, and by the behavior we're expecting for Labor Day as well. So, again, a little glimmer of hope, but this could be short live if we don't really focus in the mitigation measures that Dr. Borsa was mentioning. We have learned a lot over the past 20 months. Most of this stuff used to be in the unknown column. Now we know that this virus transmits person to person, primarily through droplets. We now know that there's some level of spread when you're not showing symptoms of the disease. We know this is not airborne it's not going to be traveling through a building, but it is going to be spreading a little bit more than droplets in a new category of transmission that we call aerosols which is just what's happens around the patient. We know that the incubation period for the majority of people is going to be five to seven days. We now know that mortality is deeply associated with age and comorbidities you're underlying illnesses, although every so often we see people with no comorbidities who are young and healthy, who unfortunately contract COVID and die. We're seeing more children dying as well which is very very disturbing to us in the medical community. This illness has unmasked racial disparities in Houston. We see communities and zip codes that are disproportionately affected by this disease. And again, we target our interventions now to make sure there's equity and that we're addressing the areas of the city that are most affected. There was a lot of focus on the environment initially in this virus. We now know that although the virus can survive in the environment for two to four days. The coats are very small and they're not very effective in transmitting the disease. So we now focus a lot more on ventilation on droplets on contact with people, rather than on cleaning the environment which is still important but not the main driver of this disease. We know that people can shed the virus long term for months at a time for some of our patients, but people are rarely infectious beyond 10 days if your immune system is working, or 20 days if you're in a compromise. Therefore, we've been able to adjust the quarantines and the return to work policies. We know this virus is susceptible to any disinfectant you have in your house. So that early therapy makes a difference. Therefore, we have been emphasizing that people that are sick with this disease seek care early on. There's this new therapy we call monoclonal antibodies that's incredibly efficacious in avoiding hospitalizations. So again, the key here is not to wait until you're too sick, because by the time you're very sick, it's been 10 days to show to the hospital. There's not a lot we can do for some people. Vaccines are highly effective. And the current level of precautions that we use for COVID work, masking works, face shields work, gloves and gowns work in the hospitals, and we need to continue this non-pharmacological interventions to control the spread. What we're still working on are relapse issues, reinfection, immunity antibodies, and of course the variants. And those are things that we're actively investigating. Talking about vaccines, Dr. Porza mentioned this. I just really want to emphasize how efficacious the vaccines we have are. The failure rate, severe failure rate for the vaccines in the United States with data from CDC shows that only six out of a thousand vaccinated people are going to end up in the hospital or unfortunately dying. That is a failure rate of .006, which is near perfect when you talk about the efficacy of the vaccines. Another graph here shows you the hospitalizations divided by vaccinated and unvaccinated people. And again, national data is showing that if you're unvaccinated, you're 17 times more likely to land in the hospital that if you're vaccinated, which is basically showing a flat curve since we started the vaccination campaign, highly, highly safe and efficacious vaccines. And yes, everybody hates masks and we were tired of wearing masks. And when CDC came out and said, if you're vaccinated, you can stop wearing a mask indoors, we all celebrated in joy. But unfortunately, Delta did change the equation. This is very interesting mathematical modeling taking into account natural immunity in the community, vaccine coverage and masking or not masking. And unfortunately, the only way to solve the equation of spreading the community right now involved wearing mask again when you're indoors. And I'm showing you here how really the safest activity you can be doing is being vaccinated and mask outdoors. Anything indoors carries a risk and it's very, very high risk for COVID when you're indoors with somebody where both of you are unmasked. That is kind of a higher situation and something we can help avoid with consistent masking messaging. What's it going to get to go back to normal? I think four things need to happen. We need to be able to control the transmission in the community a little bit more to the point where we can identify cases, isolate them, contact trace for contacts, isolate, etc. Basic public health. We need to have rapid ubiquitous molecular testing in the community. So we need to make testing not a big production. We need to make it so that you can go and test at any Walgreens at any CVS in your doctor's office, so that if you're possibly you stay home and you stop the spread of the virus. We need to unfortunately continue wearing a mask. But again, masks are vilified in this setting, but they're one of the tools are going to help us get back to normal. And finally, the PSA resistance is going to be the vaccines. And again, these four things are going to achieve what we all want, which is going back to normal. And because this is sponsored by Interfaith Ministries, I decided to finish my talk with a little phrase from my religion and my beliefs. All of you have heard this phrase, whoever saves one life saves the world entire. We need to help vaccinate our community. One vaccinated person is one life saved. One life saved saves the whole community saves the world. Thank you so much. Dr. Strausky, Dr. Porsa, thank you both. It's just amazed that you've been so informative in such a short period of time. I'm going to start with a couple of of pre submitted questions. So let me just hand this one off to you first just so that there's again, not this awkward silence. We have got a lot of questions from our faith leaders about singing during in during sacred time and I know this isn't necessarily your area of medical expertise. But, and you perhaps have been asked this question as well. I'm wondering if you could shed any light on either resources or best practices about again, singing in congregational contexts in indoors or outdoors. If you would just, Dr. Porsa, if you've got anything or else I can hand it off to Dr. Strausky, but I'll start with you, Dr. Porsa. Yeah, thank you for that. I think I'm going to like that Dr. Strausky weighing in and here it really let me let me say it this way in a group of all vaccinated people in a congregation. I cannot imagine an issue of people being able to sing a member one of the things about the community getting vaccinated was for us to be able to return to quote unquote normal life singing and in church and participating in mass events as part of that return to normalcy. So now you can return that back to a community that is only 50% vaccinated or less. Yeah, that's an issue, especially in an indoor situation. Dr. Strausky, do you have things to add again that's just such a very common question with our faith leaders. Yes, so undoubtedly singing indoors is a high risk activity we can all recall early in the pandemic there was a very publicized event where a choir was practicing and singing and they had an infection rate for about 90% of the people got infected. Fortunately, we have tools now to avoid this so we have vaccination we have masking definitely the more people vaccinated in this setting the better. Our choirs have learned to sing with mask that actually brings a very high level of protection because they contain secretions. And good ventilation and social distancing go a long way here so using our normal tools. Again helps us get back to normal and will make singing safe again. Yeah, I mean, yep. The mantra of our last 18 months. The question pre submitted as well as one in the Q&A. Is there a booster shop coming or needed if you've been vaccinated with Pfizer. I think the overall is when when my boosters be ready how will they be prioritized Dr Strausky let me start with you. Great question. We have determined that boosters or additional doses are warranted at least initially for immunocompromised host. If you're not ready available to our community you can get a third dose of either Pfizer or Moderna and we recommend people get the third dose with their initial series that they received. And again, all you need to do is a test that your immunocompromise and by immunocompromise will mean people with cancer transplants, drugs that decrease your immune system and that's again available right now, and I encourage our community to go and do it if they are in one of these categories. For the rest of the population there is emerging evidence that boosters may be useful, particularly with more infectious variants like Delta, the food and drug administration and the CC are actively evaluating this. There is a target date to start boosters at the end of September, but we're still seeing this discussions play out in the in the agencies again, but all of the hospitals all of the retail pharmacies are preparing to go live with boosters on September 20 which is the target date for the administration. Dr. Porso, do you have any supplement. Yeah, just to confirm but just for us to just said for the immunocompromise our health system and other health system we have already, we're already doing this. We're providing shots to our patients and our staff for considered high risk immunocompromise. So the booster shots I have no doubt they're going to come and potentially they may be phased in, similar to the beginning of the vaccination, high risk groups such as the healthcare people, frontline staff may go first. But again, since now the availability of vaccine is no longer an issue, it may be just be everybody eight months after the second dose of the vaccine. Thank you. There's a question. I think that's a very good one in the in the Q&A and Dr. Porso the question is this are certain masks better than others. They are but you know, I qualify that they are there are masks that are better than others but for the medical professionals who are going to be in situations where there is procedures that leads to aerosolization of the virus you know for the life masks for the general use I can tell you that for the last year and a half I have used personally, just the plain surgical masks. I visit the COVID units at both of my hospitals, every weekend. I have not developed a COVID-19 infection. So certain plain surgical masks are extremely effective for the for the routine use in the outside. Dr. Strausky, there was a question as well and I'm going to again to everyone I apologize if we can't get to every single question, but it's I think one that's on a lot of people's minds about evidence about mixing and matching shots, perhaps somebody getting a Pfizer for the two dose and then getting a Moderna probably even more more common getting the J&J the Johnson and Johnson, and then having the second dose or booster be a Pfizer Moderna. Any kind of any light to shed on this concern with or questions regarding that that next dose and what it should be based, you know, with your first dose. So, most of the research with boosters has been done with, again, the same booster as your original series and that's how boosters are being approved currently for immunocompromised patients. And most likely that's a way they're going to be approved for the general population. Having said that there's really interesting data primarily out of the UK. That started using AstraZeneca, and then they started to use Pfizer, and looks like mixing and matching may be a very good idea so emerging data but the way they're going to be approved in the United States is not mixing but more matching. Thank you. Dr. Porsa, I'm going to start with you on this question is reflected in in the chat, but particularly we're grateful to working with Congresswoman Sylvia Garcia and it was actually at a meeting that she hosted of community leaders in district 29 that the germ of this part in the 21 of this of this meeting came about. I'll just read the question verbatim please elaborate on the impact that covert 19 has had on communities of color, especially the Hispanic community, and what you as medical experts are doing to address this challenge and what this group and everyone can do as well. I think that's show for sure that communities of color, both particular Hispanic and black communities have been disproportionately hit for a host of reasons would love Dr. Porsa if you'd start with kind of your commentary on that and ways that you would see that we could address. Thank you. I think that starts to actually touched on it. Absolutely, I think, among a lot of other things that COVID-19 taught us is the is the hugely more devastating impact on our community of color. Hispanics and African Americans, our population that her cell systems are majority Hispanic and African American, but even compared to that, there was a disproportionate number of Hispanics and African Americans who were admitted to my hospital with COVID-19. And unfortunately, those who have died because of COVID-19 now there's a whole bunch of potential reasons and theories about why that may be the case. And those are not to be studied at a later time. But to answer the question about what we can do is really, really focus our communications and try to persuade our communities of color. Unfortunately, there is some mistrust. You know, Dr. Ostrowski, I think mentioned that the percentages are Mr. Harvey, the percentage of vaccination in our communities. But at the same time that our communities of colors have been most negatively impacted by COVID-19 they also seem to be the least percentage wise, least vaccinated in our community, which is a really, really terrible situation to be in. But what we can do is doing what you're doing right now, really educating the public, speaking in plain language, emphasizing what we do know about the COVID-19 infection, what we do know about the vaccine and its effectiveness and its safety. I have to say this because I had hoped that I would remember this is about COVID-19 in the pregnant woman. It is devastating to observe what is happening right now with a pregnant woman. Pregnancy puts you at an increased risk of having adverse outcome due to COVID-19. Unfortunately, from the beginning of the vaccination that has been dismissed information that the COVID-19 vaccine somehow leads to infertility or somehow has an adverse outcome of the pregnant woman is actually the opposite. There has been no evidence, nothing to suggest that COVID-19 has any impact infertility and pregnant women who are not vaccinated and are infected with COVID-19 have much, much higher chances of an adverse outcome with your pregnancy. So my recommendation, plain and simple, to all pregnant women, please, please get yourself vaccinated. If you're thinking about getting pregnant, please, please get yourself vaccinated. Thank you, Dr. Porso. And Dr. Strausky, just to give you the closing on this particular question. Absolutely. Again, I want to emphasize that the epidemiology has changed. We used to see older people with comorbidities and now we see younger people in their 40s. We have dropped two decades in the average age of admission at the TMC. We're seeing kids, we're seeing healthy kids that have no comorbidities whatsoever who should be out playing football, who are in the hospital, you know, requiring ventilatory assistance. So again, I want to really, really emphasize that vaccines save life and you by being religious leaders and people of faith can help us really save a bunch of lives by helping us drive the conversation of vaccination. Dr. Strausky, Dr. Porso, thank you so much. There are lots of other questions. And again, I'm sorry that we can't get to all of them, but there's a lot of appreciation. And to answer one question, yes, this presentation is being recorded and will be available afterwards. I'm going to go ahead and remove the spotlights. Thank you to both of you. Please stick around. We may have time to address a couple other questions. Let me introduce our next pair. A pediatrician trained at Baylor College of Medicine and Harvard Medical School. Dr. Julie Boom is the director of Texas Children's Hospital Immunization Project and director of infant and childhood immunization for the Center for Vaccine Awareness and Research. Let me just read that again. She's a trained pediatrician and the director of the Texas Children's Hospital Immunization Project. Simply said, you would be hard pressed to find a more qualified person to speak about the intersection of issues with children, COVID and vaccines, and we'll look forward to hearing from her in just a second. I'll also introduce Ms. Allison Hare, who is our regular expert from Harris County Public Health who brings updates on vaccine outreach. She rarely misses being with us on our regular Thursday 10am COVID updates for faith leaders. She's the resilience and equity officer for COVID-19 response, as well as the community resilience officer for Harris County Public Health. We'll look forward to hearing from both of you. We'll go start with Dr. Boom and have a time of question and answer. Let me get Dr. Boom highlighted and thank you for your time. There you are. Reverend Han, thank you so much. It's always a pleasure to speak to your group and to share information about how COVID is really affecting children and what we're seeing at Texas Children's. I will get that started here. Thank you. I'll go ahead and keep moving it forward. So, really, when you look at the data for Texas and our surrounding states for our children 0 to 17, you can see that this wave is hitting Texas and our surrounding states. Unlike the previous waves, we've really seen a big differences, and this is the number of new admissions for Texas and surrounding states. So, this is different. Delta has arrived and Delta has been, is really a different beast when it comes to pediatric disease. And in fact, we've been contacted by CDC and they're trying to do a quick assessment of multiple children's hospitals across the nation to get a better handle on exactly what's happening. Next slide please. So, this is what's happened to our inpatient census. And this goes back over previous waves in January and July of last year. And you can see that we've had many more children that are being admitted to Texas Children's than we've seen with previous waves. Next slide please. And this is looking at our testing also. And you can see the different lines are different mode methods for testing some are coming through and out labs like quest that you can go to and get tested. That's all of our our Texas Children's pediatric practices. Some are going through our drive through in a yellow line and other at the hospitals but overall you can see really a huge increase in the number of children that are testing positive for COVID. I do surveillance for CDC and right now about 30% of the test of all the children coming into our emergency room and inpatient floors with respiratory symptoms about 30% are positive for SARS-CoV-2. Next slide please. You know, what is the surge it's it seems to be worse we don't have that we don't know that for sure yet again CDC is looking into that, but definitely it's a more transmissible virus and we are seeing more hospitalizations as a result of that. We have seen a huge increase in a virus called RSV respiratory syncytial virus that is a virus that affects young children, especially infants. And we've had a large number of those children admitted at the same time and that's really created a big wave for children's hospitals across the country. We are seeing that children with underlying conditions are being admitted more often. We've had a few children with lung disease, children who were previously premature children with obesity have been hit very hard by COVID that's all along and we're continuing to see that. And we, and it's a concern for our unvaccinated children over 12. We, most of our children who are being hospitalized and make it to the ICU are unvaccinated. Next slide please. So again, this looks at our admissions. And I think it's really important for me to focus in on a level of ICU care. If you look at all over COVID was about 25% of children required ICU care, but just since the arrival of Delta that seems to be going up 28% and really in late COVID is 30 to 35%. So it is, we're seeing more severity at Texas Children's. And one concern that has been there since early in COVID is this phenomenon called multi multi system inflammatory syndrome in children. We have, we have admitted about 175 children with this issue. It's an overwhelming inflammatory response several weeks after your primary COVID infection, and about two thirds of those kids require ICU care. And this is potentially deadly and we have been very fortunate Texas Children's to save most of these children's lives. Next slide please. So this is a look at the children who are being vaccinated who are in the 12 to 17 year range CDC just came out with us today. And you can see that Texas is one of the lighter colors and that's not a good color to be. We want to be in the darker colors of our teams who are fully vaccinated against COVID and unfortunately you see that more on the west coast and the east coast. And for Texas, for teens who have one or more doses work 40%, but really just under 30% of children have had a complete series of vaccine. So really when you see an average teenager out and about only about one of third of them are vaccinated. Next slide please. And this is what the data looks like for Harris and surrounding counties for children 12 to 15 years of age. You can see how various counties are doing for it been is winning the vaccination race in the 12 to 15 year olds. And as you can see in Harris, for one dose we're about 55% and fully vaccinated about 36%. As we get into some more rural areas you can see that their numbers are lower. And this is concerning we're not getting the education and the vaccine out there so that these folks these children are getting vaccinated. Next slide please. Dr. Reverend Honda has asked me to answer a few questions so I'd like to answer those out front so is it safe for teens, and I think it's very important that everyone understands yes these vaccines are very safe for teens. The safety data looks very similar between teens and young adults. And so the side effects that you've heard about all along during COVID really hold true for these adolescents. Well there was a little blip if you will and concern about myocarditis and CDC has looked at this before and continuing to examine it very carefully. And really there's only a slight increase in myocarditis and when I mean slight I mean it's rare. It's a very rare phenomenon, it's especially in males, and we're seeing it after second dose, but I mean a few per 100,000. This this is really rare and they seem to be self resolving cases that do not last have any long term effects. So, really important to emphasize that you are more likely to have myocarditis after a case of COVID, then you are from the vaccine. So much worse to get COVID and get myocarditis from that and it's much more common. So we really need to encourage our families, not to have that as a reason not to get back vaccinated. And short term effects have already kind of mentioned that long term effects, we are not seeing that that should not be a concern and infertility was always already spoken about, and that is a myth. And it was a myth with previous vaccines that we've seen with adolescents in it, it is not true for COVID vaccine so that again that should not be a reason to hold back. And then finally, what about children vaccines for younger children for those that are, you know, in the younger five to 11 or less in five range. My understanding from some of my colleagues who are doing those studies at Texas Children's is that those studies are have completed enrollment and they're wrapping up gathering all their data in the next week or so. And then Pfizer should be examining that data over the coming weeks and we hope submitting that to the FDA, maybe in early October, it does seem like things have slowed down and FDA review that certainly had to had a lot to attend to. But we do hope in early to late October that we will at least hear that they are reviewing it and maybe by early November that we could potentially have vaccine for our school age children. Dr. Boom. Thank you so much for for that. Again, really helpful summary. What are you hearing about concerns. Me and others have gone back to school over the last, you know, 10 days or so and what are you hearing about data that's coming out about and about COVID spread, especially with in populations where where the work children can't get vaccinated. What are what are you hearing what what concerns would you want to address or at least perhaps shed some more light on. Absolutely. I was just watching the morning news this morning early and saw the different school districts where they either had one school closed down or several have just gone completely virtual for a little while. And I really want to emphasize mass work. And this is really what we need to get our school districts doing. I have a anecdotal report today about the mask wearing versus the incident in COVID in these schools, and the schools that are that are really requiring mass to be used are seeing a lower incidence of spread of the Delta variant amongst their children. So we, we really need to emphasize whether it's a personal responsibility sending your child to school at the mask. And I'll be honest with you, kids don't really care about the mask, whether I'm in clinic, or in my home life. This is not a big deal to them you tell them to put it on and they wear it. I think it's the parents that are worried about the kids and wearing the mask and oh I don't want to inconvenience my child. This is a way to keep your child safe, and to keep the other children at school safe to keep our teachers safe, and to stay in school, and being in school is very developmentally important for children. It's their work, it's what they are learning to do in life, and so we need to continue to, to support that especially as coven is going to be with us it's not going away. So we need to figure out how to operate within this world. Thank you, I think the final question is, then it may just be sort of a summation of what you've what you've shared with us. I guess your message to parents of children, again, 15 to 12 but particularly in anticipation of the of the vaccine, again, sooner rather than later becoming available to 11 and younger to address vaccine hesitancy for for parents with their young children what's what's your message to them. Absolutely. It is so important when your child is eligible for a vaccine. So 12 and up that means now. And as these we get to younger age groups, take your child and have them vaccinated. Take your child and have them vaccinated that's the best thing that you can do to keep them safe to keep them in school, and really to keep those around them safe if those are adults, because we do know children spread disease. And we want to do everything we can to keep our children healthy. Dr boom thank you for your time so very very much. Let me now turn to Allison here, let me go ahead and bring her up. And here she comes to share again about vaccines and vaccine availability and vaccine distribution efforts. Allison. Good evening everyone. Thank you for having me. As Reverend Han mentioned I've been on these calls numerous times and when I was asked to come to this call again. I thought it was. Excuse me. I thought it was crucial to come to this call as well because throughout the response. It has been our partnership with houses of worship with the faith community that have allowed us to reach many of the communities where we're providing both testing and vaccines. And some of our most successful vaccine operations have been through houses of worship and so I'm very happy to be able to speak with you all today and hopefully continue this very fruitful relationship for the community. And just to add a little bit everything up. You know, Bob was mentioning before we were talking about hospitalizations as we're, as we're the doctors the hospitalizations we're talking about infection rates, and all of that comes together we see all of that information and that's why the county currently has a threat level of red, which means that we are asking everyone to mask up, wash their hands socially distance and that's because we have pervasive local spread. As is mentioned this is mostly largely due to the Delta variant but what's very important is that even if we are vaccinated, we can still spread COVID-19 so the important part is to make sure that you continue with those practices that we've been asking since day one for the last 18 to 20 months where your mask, get tested if you feel symptomatic, or if you feel that you've been exposed and make sure that you just wear that mask I'm going to, I'm going to just reiterate Dr. Boom's message as well that mask is crucial. So a little bit. You've already heard the vaccine data so I won't go over that. But one thing that is really important as we're getting into these numbers we're looking at 60% vaccinated closing in on 70% vaccinated. This is the point where each arm counts. We're not looking at thousands of people getting vaccinated all at once. It's arm by arm and that's where we can make a difference currently is every person that we can convince to get a vaccine that's one more arm that's one more person that's vaccinated and it's great for them it's great for their family and it's great for the broader community. So if there's one thing that I can ask of all of you which I feel like I get on these calls and that's all I ever do is ask of you, but please amplify our message amplify the message that it's important to get vaccinated each arm counts each mask counts. And, and that's what's going to get us to the end of the road. A little bit of information I know lots of folks have heard about this I definitely wanted to start off with this it's kind of good news. Our incentive program I believe everybody has heard about the cash cards if you go to a Harris County public health vaccine site and it's your first dose. You can get a link to a cash card that same day. And then we were able to open up this, the cash card incentive program to all to other providers. So you can go to a Walgreens you can go to a CVS. What you have to do is you go online you fill out a form, and within about seven to 14 days because we have to go into the state system and verify and all that kind of stuff so it takes a little bit longer. But within seven to 14 days you'll have a link to $100 cash gift card to be used anywhere as you wish however you want. The idea being that we've heard from a lot of folks especially folks that work hourly wage jobs. They don't have the time to go get a vaccine an hour or two hours that cost them quite a bit of money so the idea being that if we can provide that cash card it to phrase a little bit that that that Otis that monetary ownership that might that might that they might have by trying to get a vaccine so that's that's moving forward. As the good news is it's been extended to September 14. So you have any folks that still need to get their first vaccine they still have 12 more days to go ahead and get that vaccine, any location within the county, and they can get $100 cash. The other important thing to note it's not by family it's by individuals so if it's you, your partner and your three children are all eligible and you all go get your vaccine that is $400 in your pocket. So, that's something important to note. That's another important thing to note I believe everybody knows that the Mayor started super Saturdays at schools we have vaccination program through schools. Each ISD has their different sites. So we, we are also partnering with them on that so you can see us at a number of school sites as well. And then as per usual, I wanted to let everybody know we do have permanent sites specifically for vaccines I know everybody knew that we had one at NRG we had to move that one it's currently at Dick graves park. And all of this information I'm going to share with Reverend Hawn and he'll be able to send it into with the updates after this call, but just wanted to let make sure that everybody knew at Dick graves park which is at 2000 read road. We do both vaccine and testing so you can do your one stop shopping right there. Of course if you're symptomatic, you can get a test but you can't get a vaccine, but hopefully you're not symptomatic and you might as well just go ahead and get both and fun for all. But it just kind of an easy thing to remember if I need anything COVID related I can always go to Dick graves park. We also have another new location we were we had been at Sheldon ISD Panther Stadium, and this evening the team is moving that over to the Bear Creek AgriLife Center out on highway six. So that's another location that you can get vaccines. And then we as always we have our three testing locations which are at Lone Star College in Cyprus, the San Jet College, Central Campus and Pasadena and East Aldeen. And we'll send out the links for registration for both vaccines and testing. But the important thing to note is that we also have call centers to the internet can always use the call centers to make an appointment either for vaccines or for testing. And that number is 832-927-8787. And again, I'll send that out later. And I was looking at some of the questions that we got I think previously, and before I end I did want to speak a little bit about how we choose locations and so I always talk about what we have the three locations around the county but something that we're trying to do is one of the things we look at is social vulnerability index. Where are the folks that need us most and where are they traditionally in the Houston-Harris County area? And that's where we're trying to focus not only our vaccine sites, our testing sites, but our messaging as well and our outreach efforts. Everything that we do gets focused on those priorities and codes. And that's looking at social vulnerability index that's looking at the historical incidents of COVID over the last 18 months as well as recent recent incidences of COVID. And we also look at where there might be what I call vaccine or testing deserts. So where are we lacking providers that provide those services as well as, excuse me. And then the other thing we're looking at is geographic being across across the county geographically so that folks don't have to travel too far in order to make it to a vaccine or testing site. So those are some of the things that we try to do to ensure equity and all of our practices and all of our responses. The other things that we do is that we have at home testing and vaccinations. So if you for some reason can't travel out, you need someone to come to your home, we do provide testing and vaccines at the home. If you have transportation as an issue we provide taxi services to a vaccine site you can also and all of this can be found through that number I gave you can call that number. And then finally, another thing, an important note is if folks are calling our call centers, we have multi-lingual agents. So they speak English Spanish Chinese or excuse me Mandarin Vietnamese, and they have access to other languages as well. So what we're trying to do is just bring down all those barriers to access that we keep hearing about and so we try to be as accessible as possible to everyone. And finally, this is something that I think is incredibly important. We never ask for an ID. We don't ask for insurance and we don't ask for payment. It's completely free ID free paper free will not ask. We just ask for some information basically how to get in touch with you so that we could get in touch and tell you about your second dose or once it's available third dose. That way we can just get in touch and let you know it's time for your next dose. And finally, as always, how we can work together. I will provide my email and my and my phone number as well but if you would like to be a testing or excuse me a vaccine site please feel free to reach out to me we're always setting up new vaccines sites. We're currently because of high demand, we would prefer indoor sites that might be able to service 100 to 300 people. But again, like I said, a vaccinated arm is a vaccinated arm so if you have a smaller space will work with you and we'll try to get you on that schedule. So thank you and I'll answer any questions. Alison thanks mindful of the time so just please send me any information and I will include that in the post email follow up so but as always thank you for being with us. At this time I usually show some announcements but we've looked to really maximize our presentation time so please be on the lookout for a follow up email and and by registering you are for this you're now kind of part of our coven support community. Let me now recognize Mr Martin Kaminsky, President and CEO of Interfaith Ministries for our closing for some closing words. Greg, thank you very much for moderating tonight's program and let me thank all the medical professionals on this call and every other call we have. You've given so much time and valuable information to us time and time again whether it's morning noon or night. So we're very grateful to you. I'm also always happy to be with my partner, Bob Harvey in the Greater Houston partnership, and the support that they give all of our community to trying to keep us to be a greater Houston, a healthy Houston and you can do your part by getting your vaccine. Finally, I'd just like to remember at this time that not only are we addressing the needs of coven, but we have many new Houstonians coming to our town from Afghanistan. Interfaith Ministries is also responsible for refugee resettlement. We're now working on a program that's 1000 neighbors 1000 reasons, and we hope that you'll join us in welcoming new people to our community that need our support in every way at this time. More information is available at IMGH.org. So with that said, Greg, and to all our presenters. Thank you very much. This concludes this evening's program.